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CPT code 12034: Wound repair, intermediate, 7.6–12.5 cm2026 Medicare rate & RVUs in Manhattan, NY

Reports intermediate layered closure of qualifying wounds on the scalp, axillae, trunk, or extremities, excluding hands and feet, totaling 7.6–12.5 cm.

CMS RVU26DEffective Oct 1, 2026One payment locality35.9K Medicare services in 2024

In Manhattan, NY, Medicare pays $384.93 for 12034 in the office and $205.23 when it’s performed in a hospital or facility.

$384.93Office (non-facility)
$205.23Hospital or facility
+15.0%vs the national office rate ($334.68)

Check a contract rate as a % of Medicare · 12034 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 12034 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Manhattan, NY
  2. What 12034 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 12034 covers

This service covers closure of a wound that needs more than a simple skin-layer repair, such as layered closure involving deeper subcutaneous tissue or superficial fascia. It can also describe single-layer closure of a heavily contaminated wound after extensive cleaning. The wound must be on the scalp, axillae, trunk, or an extremity; hands and feet are classified elsewhere. Physicians and other qualified practitioners commonly perform these repairs in offices, emergency departments, and other outpatient settings after lacerations or similar injuries.

Select the code based on repair complexity, anatomic group, and total repaired length. Add lengths of qualifying wounds in the same repair category and anatomic group; document each wound’s site, length, tissue layers closed, and any extensive cleaning. The service has a 10-day global period, which includes related postoperative visits during that period. For multiple procedures in one session, Medicare pays the highest-valued procedure in full and other procedures at 50%. Modifier 50 is not appropriate. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Manhattan, NY compares for 12034

Across 109 of 109 payment localities, the office rate for 12034 runs from $296.66 in Arkansas to $438.64 in San Benito County, CA. Manhattan, NY pays $384.93. The RVUs are the same everywhere; the geographic indexes change the dollars.

12034 in Manhattan, NY vs other payment areas
  1. Manhattan, NY · this page$384.93
  2. NYC suburbs and Long Island, NY · New York$394.52+$9.59
  3. Poughkeepsie and northern NYC suburbs, NY · New York$363.13−$21.80
  4. Queens, NY · New York$387.55+$2.62
  5. Rest of New York · New York$319.57−$65.36
  6. Los Angeles, CA · California$375.41−$9.52
  7. Washington, DC area · District of Columbia$381.39−$3.54

Other areas in New York first, then benchmark localities. Bars start at $0.

Every other payment area

12034 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$363.81$202.82
Chicago, ILIllinois$353.35$197.93
AlaskaAlaska$391.87$227.17
AlabamaAlabama$300.93$165.61
ArkansasArkansas$296.66$163.82
ArizonaArizona$325.83$175.98
Bakersfield, CACalifornia$353.00$183.51
Chico, CACalifornia$351.86$182.37

12034 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$296.66

$395.25

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
12034 office rate range by state
State / territoryOffice rate rangeLocalities
AK$391.871
AL$300.931
AR$296.661
AZ$325.831
CA$351.86–$438.6429
CO$347.371
CT$356.661
DC$381.391
DE$331.151
FL$331.34–$363.813
GA$312.90–$341.182
GU$359.991
HI$359.991
IA$307.721
ID$309.831
IL$322.45–$353.354
IN$311.571
KS$306.641
KY$308.621
LA$308.28–$323.192
MA$345.50–$380.822
MD$337.27–$381.393
ME$311.77–$327.852
MI$316.80–$335.752
MN$332.031
MO$303.32–$323.913
MS$300.031
MT$334.651
NC$314.911
ND$326.941
NE$309.271
NH$342.271
NJ$360.50–$377.632
NM$318.641
NV$332.731
NY$319.57–$394.525
OH$315.221
OK$307.721
OR$329.91–$357.842
PA$315.53–$348.152
PR$336.951
RI$342.531
SC$315.641
SD$326.031
TN$308.191
TX$313.52–$346.428
UT$319.861
VA$327.03–$381.392
VI$336.951
VT$325.991
WA$344.74–$388.162
WI$316.221
WV$310.841
WY$331.291

See 12034 in every payment locality

How the 12034 rate is calculated

Each of 12034’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 12034

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.90

2.90 RVUs× 1.000 GPCI

Practice expense6.73

6.73 RVUs× 1.000 GPCI

Malpractice0.39

0.39 RVUs× 1.000 GPCI

Adjusted RVUs

10.0200

Conversion factor

$33.4009

Medicare rate

$334.68

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Manhattan, NY inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,414

Code
12034
Physician work
2.90
Practice expense
6.73
Malpractice
0.39

GPCI2026.csv

78

Locality
Manhattan, NY
Physician work
1.064
Practice expense
1.162
Malpractice
1.586
Office calculation for 12034 in Manhattan, NY
ComponentRVULocality factorAdjusted
Physician work2.90× 1.0643.0856
Practice expense6.73× 1.1627.8203
Malpractice0.39× 1.5860.6185
Total RVUs11.5244
Conversion factor× 33.4009

Office rate, Manhattan, NY$384.93

Office: (2.9 × 1.064 + 6.73 × 1.162 + 0.39 × 1.586) × $33.4009 = $384.93

Facility: (2.9 × 1.064 + 2.1 × 1.162 + 0.39 × 1.586) × $33.4009 = $205.23

Open 12034 in the RVU calculator

Payment rules and modifiers for 12034

12034 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 12034

Wound repair, intermediate, 7.6–12.5 cm

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 12034

Wound repair, intermediate, 7.6–12.5 cm

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

12034 without 51 · national office

$334.68

Wound repair, intermediate, 7.6–12.5 cm

12034-51 · Second procedure: 50%

$167.34

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 12034

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 12034
CodeHow it relatesOffice range, Manhattan, NY
Used instead
12004Simple wound repair, nonfacial sites, 7.6–12.5 cmSimple repair for the corresponding scalp, trunk, or extremity group when the wound needs only simple closure.$188.33
Same family
12032Intermediate repair, 2.6–7.5 cm, scalp/trunk/extremitiesIntermediate repair in the same anatomic group for a shorter total wound length.$344.16
12035Wound repair, intermediate, 12.6–20 cmIntermediate repair in the same anatomic group for a longer total wound length.$478.89
12037Intermediate repair, over 30 cm, scalp/trunk/extremitiesIntermediate repair in the same anatomic group when total length exceeds this code’s range.$622.11
12041Intermediate repair, neck, hands, feet, genitalia, 2.5 cm or lessIntermediate repair for the separate neck, hands, feet, or genitalia anatomic group.$302.28
12044Intermediate repair, neck, hands, feet, or genitaliaIntermediate repair for the separate neck, hands, feet, or genitalia group at a comparable length.$447.04

How 12034 has changed in Manhattan, NY

12034 · Office / nonfacility

$384.93

Effective 2026-10-01

The base rate is $11.67 higher than on 2025-10-01, moving from $373.26 to $384.93 (3.1%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $373.26changed to$384.93

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.97 changed to 2.90
    • Practice expense RVU 6.63 changed to 6.73
    • Work GPCI 1.065 changed to 1.064
    • Practice expense GPCI 1.166 changed to 1.162
    • Malpractice GPCI 1.656 changed to 1.586

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $387.39changed to$373.26

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 6.70 changed to 6.63
    • Malpractice RVU 0.40 changed to 0.39

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $381.07changed to$387.39

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $399.78changed to$381.07

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 6.68 changed to 6.70
    • Work GPCI 1.061 changed to 1.065
    • Practice expense GPCI 1.184 changed to 1.166
    • Malpractice GPCI 1.843 changed to 1.656

  5. January 1, 2023

    RVU23A

    $412.67changed to$399.78

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.63 changed to 6.68
    • Work GPCI 1.056 changed to 1.061
    • Practice expense GPCI 1.203 changed to 1.184
    • Malpractice GPCI 2.031 changed to 1.843

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $412.60changed to$412.67

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 6.53 changed to 6.63
    • Malpractice RVU 0.41 changed to 0.40

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $392.04changed to$412.60

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.86 changed to 6.53
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.192 changed to 1.203
    • Malpractice GPCI 1.823 changed to 2.031

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $379.22changed to$392.04

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.64 changed to 5.86
    • Malpractice RVU 0.46 changed to 0.41
    • Work GPCI 1.052 changed to 1.054
    • Practice expense GPCI 1.180 changed to 1.192
    • Malpractice GPCI 1.615 changed to 1.823

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $372.75changed to$379.22

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.47 changed to 5.64
    • Malpractice RVU 0.48 changed to 0.46

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $369.19changed to$372.75

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.41 changed to 5.47
    • Practice expense GPCI 1.174 changed to 1.180
    • Malpractice GPCI 1.690 changed to 1.615

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $366.75changed to$369.19

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.37 changed to 5.41
    • Practice expense GPCI 1.168 changed to 1.174
    • Malpractice GPCI 1.764 changed to 1.690

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $366.81changed to$366.75

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.46 changed to 0.48

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $364.99changed to$366.81

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $357.66changed to$364.99

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.25 changed to 5.37
    • Malpractice RVU 0.48 changed to 0.46
    • Work GPCI 1.057 changed to 1.052
    • Practice expense GPCI 1.165 changed to 1.168
    • Malpractice GPCI 1.518 changed to 1.764

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $362.98changed to$357.66

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.92 changed to 5.25
    • Malpractice RVU 0.50 changed to 0.48
    • Work GPCI 1.062 changed to 1.057
    • Practice expense GPCI 1.162 changed to 1.165
    • Malpractice GPCI 1.271 changed to 1.518

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $362.98

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$384.93$205.23RVU26D
2026-07-01$384.93$205.23RVU26C
2026-04-01$384.93$205.23RVU26B
2026-01-01$384.93$205.23RVU26A
2025-10-01$373.26$229.94RVU25D
2025-07-01$373.26$229.94RVU25C
2025-04-01$373.26$229.94RVU25B
2025-01-01$373.26$229.94RVU25A
2024-10-01$387.39$235.24RVU24D
2024-07-01$387.39$235.24RVU24C
2024-04-01$387.39$235.24RVU24B
2024-03-09$387.39$235.24RVU24AR
2024-01-01$381.07$231.40RVU24A
2023-10-01$399.78$241.30RVU23D
2023-07-01$399.78$241.30RVU23C
2023-04-01$399.78$241.30RVU23B
2023-01-01$399.78$241.30RVU23A
2022-10-01$412.67$246.14RVU22D
2022-07-01$412.67$246.14RVU22C
2022-04-01$412.67$246.14RVU22B
2022-01-01$412.67$246.14RVU22A
2021-10-01$412.60$247.63RVU21D
2021-07-01$412.60$247.63RVU21C
2021-04-01$412.60$247.63RVU21B
2021-01-01$412.60$247.63RVU21A
2020-10-01$392.04$248.79RVU20D
2020-07-01$392.04$248.79RVU20C
2020-04-01$392.04$248.79RVU20B
2020-01-01$392.04$248.79RVU20A
2019-10-01$379.22$246.97RVU19D
2019-07-01$379.22$246.97RVU19C
2019-04-01$379.22$246.97RVU19B
2019-01-01$379.22$246.97RVU19A
2018-10-01$372.75$248.28RVU18D
2018-07-01$372.75$248.28RVU18C
2018-04-01$372.75$248.28RVU18B
2018-01-01$372.75$248.28RVU18AR1
2017-10-01$369.19$247.84RVU17D
2017-07-01$369.19$247.84RVU17C
2017-04-01$369.19$247.84RVU17B
2017-01-01$369.19$247.84RVU17A
2016-10-01$366.75$246.31RVU16D
2016-07-01$366.75$246.31RVU16C
2016-04-01$366.75$246.31RVU16B
2016-01-01$366.75$246.31RVU16A
2015-10-01$366.81$246.36RVU15D
2015-07-01$366.81$246.36RVU15C
2015-04-01$364.99$245.13RVU15B
2015-01-01$364.99$245.13RVU15A
2014-10-01$357.66$239.97RVU14D
2014-07-01$357.66$239.97RVU14C
2014-04-01$357.66$239.97RVU14B
2014-01-01$357.66$239.97RVU14A
2013-10-01$362.98$235.68RVU13D
2013-07-01$362.98$235.68RVU13C
2013-04-01$362.98$235.68RVU13B
2013-01-01$362.98$235.68RVU13AR

Price 12034 for an earlier date of service

Where the Manhattan, NY rate applies

Manhattan, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

12034 billing questions

What makes this an intermediate repair rather than a simple repair?

Intermediate repair involves layered closure of deeper tissue as well as skin, or single-layer closure of a heavily contaminated wound requiring extensive cleaning. A routine skin-layer closure is not enough to support this code.

Which wound locations qualify?

The covered group is scalp, axillae, trunk, and extremities, excluding hands and feet. Face and mucous membrane repairs, and repairs in the separate neck, genitalia, hands, or feet group, use different code selections.

How should multiple wounds be counted?

Add lengths of wounds that share the same repair category and anatomic group to select the length-based code. Document the individual wound sites and lengths; Medicare’s multiple-procedure payment reduction is a separate issue when multiple procedures are performed in one session.

Is modifier 50 appropriate for wounds on both sides?

No. Modifier 50 is not appropriate for this code; select the repair code from the applicable anatomic group and total repaired length.

Are postoperative visits separately reported during the global period?

Related postoperative visits during the 10-day global period are included in the procedure’s payment.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 12034PPRRVU2026_Oct_nonQPP.csv, line 1,414 (RVU26D)
Geographic factors for Manhattan, NYGPCI2026.csv, line 78 (RVU26D)

Open CMS sourceHow we calculate rates

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